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Title Type of HRT and risk of stroke
Date 16 July 2010
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Recently reported in the British Medical Journal, a study has suggested that the risk of stroke associated with the use of HRT is affected by the type of HRT used.

Data from the UK based General Practice Research Database of women aged 50-79 years between 1 January 1987 and 31 October 2006 were examined, looking at use of HRT and which type along with incidence of stroke. Results showed that women taking tablet form of HRT had a slightly higher risk of stroke than non-HRT users, while women taking low dose estrogen patches had no increased risk. There was an increase in high dose estrogen patches.

It is known that there are differences in systems such as production of substances involved in the blood clotting system with use of tablet or transdermal estrogen; there being a small increased risk of venous thrombosis with tablet, but not transdermal (patch or gel) therapy. With this study being observational, definite conclusions cannot be made but in the case of stroke risk, it is important to address risk factors such as control of high blood pressure, and if HRT is used, it would seem sensible to use low dose transdermal estrogen.

Ref Transdermal and oral hormone replacement  therapy and the risk of stroke: a nested case-control study.

Renoux C, Dell’aniello S, Garbe E, Suissa S.

BMJ 2010. Jun 3;340

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